C1-C2 Rotatory Subluxation in Adults “A Narrative Review”
David C. Noriega González,
Francisco Ardura Aragón,
Jesús Crespo Sanjuan,
Silvia Santiago Maniega,
Alejandro León Andrino,
Rubén García Fraile,
Gregorio Labrador Hernández,
Juan Calabia-Campo,
Alberto Caballero-García,
Alfredo Córdova-Martínez
Affiliations
David C. Noriega González
Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain
Francisco Ardura Aragón
Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain
Jesús Crespo Sanjuan
Department of Orthopedic, Clinic University Hospital of Valladolid, 47005 Valladolid, Spain
Silvia Santiago Maniega
Department of Orthopedic, Clinic University Hospital of Valladolid, 47005 Valladolid, Spain
Alejandro León Andrino
Department of Orthopedic, Clinic University Hospital of Valladolid, 47005 Valladolid, Spain
Rubén García Fraile
Department of Orthopedic, Clinic University Hospital of Valladolid, 47005 Valladolid, Spain
Gregorio Labrador Hernández
Department of Orthopedic, Clinic University Hospital of Valladolid, 47005 Valladolid, Spain
Juan Calabia-Campo
Department of Radiology, Clinic University Hospital of Valladolid, 47005 Valladolid, Spain
Alberto Caballero-García
Department of Anatomy and Radiology, Health Sciences Faculty, GIR: “Physical Exercise and Aging”, University of Valladolid, Campus Universitario “Los Pajaritos”, 42004 Soria, Spain
Alfredo Córdova-Martínez
Department of Biochemistry, Molecular Biology and Physiology, Health Sciences Faculty, GIR: “Physical Exercise and Aging”, University of Valladolid, Campus Universitario “Los Pajaritos”, 42004 Soria, Spain
The atlantoaxial joint C2 (axis) with the anterior arch of C1 (atlas) allows 50% of cervical lateral rotation. It is responsible for precise and important movements that allow us to perform precise actions, both in normal and working life. Due to low incidence in adults, this condition often goes undiagnosed, or the diagnosis is delayed and the outcome is worse. An early diagnosis and treatment are essential to ensure satisfactory neurological and functional outcomes. The aim of this review is to analyze C1-C2 rotatory subluxation in adults, given its rarity. The time between injury and reduction is key, as it is directly related to prognosis and the severity of the treatment options. Due to low incidence in adults, this condition often goes undiagnosed, or the diagnosis is delayed as a lot of cases are not related to a clear trauma, with a poor prognosis just because of the late diagnosis and the outcome is worse. The correct approach and treatment of atlantoaxial dislocation requires a careful study of the radiological findings to decide the direction and plane of the dislocation, and the search for associated skeletal anomalies.
